Gastrocnemius Tendonitis

Gastrocnemius tendinopathy

Gastrocnemius tendonitis is inflammation of the gastrocnemius tendon. It is one of the calf muscles at the back of the lower leg. It is an overuse injury which is more common in runners and sprinters.


  • Symptoms include gradual onset pain at the back of the knee.
  • Tenderness will be felt at the origin of the calf muscle, just behind the knee.
  • Pain is reproduced by resisted bending of the knee (knee flexion).
  • Performing calf raise exercises with a straight leg, or hopping on the bad leg may reproduce symptoms.
  • Sometimes calf stretches may also be painful, but not always.

What causes Gastrocnemius tendonitis?

Calf tendonitis is an overuse injury. The term tendinitis is often used which indicates inflammation. This is more likely if the injury is recent or acute. If it has been coming on gradually, then it is possible your injury is more degeneration rather than acute inflammation. Therefore, tendinopathy is often a more appropriate term.

Common causes:

  • Increasing running mileage too soon.
  • Doing too much high intensity sprinting.
  • If there is muscle imbalance in the hip or knee joints, or if the athlete has poor foot biomechanics.
  • Wearing incorrect or poorly fitting footwear should also be considered.

Treatment for Gastrocnemius tendonitis

Initial treatment consists of applying the PRICE principles of protection, rest, ice, compression, and elevation.

  • Rest is important to protect from further damage and allow the injury to heal. In minor cases, this may initially consist of modifying training, for example, avoiding sprinting if it hurts to run fast, or avoiding running altogether in favour of cycling or similar.
  • Ice will help reduce pain and inflammation and is very important in the early stages (48 to 72 hours). Once the initial pain and inflammation has gone a gradual stretching and strengthening program should be done. This will ensure the injury does not recur once normal training loads are applied again.
  • A knee support or heat retainer may help by protecting and supporting the area and keeping the tendon warm when returning to training activities.

What can a sports injury professional do?

  • A professional therapist can make an accurate diagnosis and may use electrotherapy such as ultrasound to help reduce pain and inflammation.
  • A doctor may prescribe anti-inflammatory medication such as Ibuprofen in the early stages to help reduce pain and inflammation, although long-term use is not thought to aid the healing process.


Sports massage to the calf muscles is important to help relax and stretch the muscle which will reduce the strain on the tendon and enable the muscle to function better during activity. Local cross friction massage to the tendon itself may be used in more chronic cases.

Exercises for Gastrocnemius tendonitis

  • Stretching exercises for the calf muscle in particular and the hamstring muscle should be done as soon as pain allows and maintained throughout the rehabilitation process and beyond.

Go to calf stretching exercises.

  • Strengthening exercises for the calf muscles can also begin after the acute stage as long as they can be done pain-free.
  • For more severe injuries this may start with simple plantar flexion exercises with a resistance band and progress to calf raise exercises on a step.
  • Begin with both legs and as strength and confidence improve this can be developed to single leg calf raises.

Go to calf strenthening exercises.

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